Reshaping ICU bedspace into a calm, comfortable environment where patients thrive
March 30, 2023
Bright lights and constant alarms are synonymous with hospitals but can be debilitating for ICU patients
Admission to most hospitals usually means exposure to harsh and artificial lighting, bland and sterile walls and surfaces, and constant alarms. These conditions cause anxiety and negatively impact recovery for many patients, especially for intensive care unit (ICU) patients who need a healing environment to optimise recovery.
One in two Australians will be exposed to an ICU in their lifetime and up to 75 percent of patients will experience physical, psychological, as well as cognitive?problems after an ICU admission. It doesn¡¯t just impact the patient either. Findings show that many family members develop problems after ICU admission, including post-traumatic stress disorder.
Five years ago, a group of researchers from The Prince Charles Hospital (TPCH) Critical Care Research Group (CCRG), supported by the hospital foundation ¡®The Common Good, an initiative of The Prince Charles Hospital Foundation¡¯, started working with ICU clinicians, former patients and their families, and industry partners to address these issues. The goal was simple: create an environment that improves patient experiences and outcomes, where patients feel comfortable, secure, and safe.
ICU room from the Prince Charles Hospital in Brisbane. (Credit: Critical Care Research Group)
Creating the ICU of the Future
The goal of the project was to create a more hospitable ICU environment and improve patient quality of life after discharge.
While ICUs operate differently around the world with varying cohorts of patients, there¡¯s a lot of overlap and similarities in how patients perceive critical care units and how the ICU environment impacts their recovery outcomes. Their experiences can be quite traumatic. The research team interviewed former patients and their family members about their experience in ICU and used the information to define what needed to be changed in the ICU bedspaces.
With over 150,000 admissions across Australia annually, there were no shortages of participants¡ªwhich is why this research and project is so important. The findings uncovered key themes needing to be addressed. The interdisciplinary project team incorporated evidence-based design and bespoke technologies to optimise patient care and reduce patient distress by focusing on four key areas: (1) optimising lighting, (2) reducing noise and alarms, (3) improving patient connectivity with the outside world, and (4) creating a calming and more homely design. Two bedspaces were rebuilt to address these challenges and were completed and ready for patients in January 2023.
Simulated natural light
Sleep plays a major role in health and wellbeing. When we don¡¯t get sufficient sleep, multiple body systems are disrupted¡ªfrom your endocrine system through to your nervous and immune system.
Standard fluorescent lighting is a key disruptor to our natural circadian rhythm even when a window is nearby. The light quality doesn¡¯t only affect patients, it also affects family members, visitors and hospital staff. The ICU of the Future bedspaces incorporates a bespoke circadian lighting solution to help mimic natural light and support the natural sleep pattern. This means that the light will change depending on the time of day, via large LED light panels above the patients¡¯ head and recessed LED perimeter strip lighting.
Prince Charles ICU. (Credit: Critical Care Research Group)
Reducing noise and stress
The noise levels and number of alarms are very high in the ICU unit, with most of the noise occurring close to the patient¡¯s head. For example, multiple infusion devices, monitors, and ventilators are all located within a metre of the patient¡¯s head, creating both electrical and alarm noise.
The ICU of the Future team conducted an audit in The Prince Charles Hospital ICU to establish the frequency of alarms occurring. They found that the monitors alone created 600,000 alarms per month for an average of 20 occupied beds. That means that for each bedspace an alarm is going off every 80 seconds throughout the day and night, with only 5 percent of those being actioned, the rest being less critical.
Noise can increase cortisol levels, an important stress hormone, which can further reduce patient¡¯s sleep quality and quantity, increasing the likelihood of sleep deprivation. Through cleanable acoustic paneling, low-noise ductwork, and grilles, we managed to help our client reduce noise pollution and set the benchmark to lower stress to the patients.?
One in two Australians will be exposed to an ICU in their lifetime and up to 75 percent of patients will experience physical, psychological, and/or cognitive problems after an ICU admission.
Improving how patients connect with loved ones
The support of loved ones can make all the difference to patients. Digital windows have been included to provide a view in the windowless bedspaces, and patients can use virtual visiting to connect with their families and the outside world. These virtual windows add to the aesthetic of the room and create a calming effect. Patients can choose the scene according to their mood and personal preferences. ?
Simulated natural light to mimic natural circadian rhythm. (Credit: Critical Care Research Group)
Calming design to feel like a hotel room
Through patient-centred design, rooms feel less clinical and more homely. The use of anti-infection acoustics panels helps absorb noise created in the bedspaces, equipment has been reconfigured and moved to be less disturbing for patients while maintaining clinical efficiencies, and the project has improved patient comfort levels with user-friendly, state-of-the-art beds and improved connectivity. Patients can chat to loved ones, check the weather or catch an episode of their favourite shows if they need a distraction.
These design elements are enhancing the patient experience and are expected to generate positive patient outcomes. With patients and their families at the core, the ICU of the Future project aims to improve recovery and wellbeing by reducing the incidence of physical, psychological and cognitive problems that patients commonly experience¡ªultimately improving quality of life for people after ICU admissions with the added benefit of reducing the need for ongoing care.
You can experience the ICU of the Future by taking this .